Brant County Community Health Status Report: 2001 OVERVIEW

Brant County Community Health Status Report: 2001 OVERVIEW Brantford County of Brant Brant County Health Unit and Grand River District Health Council April 2001

Brant County Community Health Status Report: 2001 Produced jointly by the Brant County Health Unit and the Grand River District Health Council, the Brant County Community Health Status Report (CHSR): 2001 builds on the first report produced in 1996. It is intended to serve as a resource to health and social service organizations, providing information on the health and health determinants of Brant County residents. The Brant County CHSR contains chapters focusing on demographics, reproductive health, lifestyles and determinants of health, as well as the causes of disease and death. Information is analyzed by age and sex, and is compared to all of Ontario. Please refer to the full report for details on any of the topics and chapters discussed in this Overview. THE COMMUNITY?? Brant County covers a geographic area of 1,091 km 2, which includes the City of Brantford and the County of Brant. The amalgamated County of Brant includes the former Town of Paris and the Townships of South Dumfries, Burford, Brantford, Oakland, and Onondaga.?? 18% of the residents of Brant County live in rural settings while 82% live in urban centres (i.e., Brantford and Paris).?? The population estimate for Brant County in 2001 is 126,830, based on projections from the 1996 Census, which includes estimates for Six Nations and New Credit Reserves. In 1996 it was 117,721, excluding Six Nations and New Credit Reserves.?? More than a quarter of the Brant County population includes people under the age of 10 (14%) or over the age of 65 (14%). Projected Population Growth for Brant County by Age Group, 1996-2016 100% 75% 50% 25% 0% -25% -50% 0-4 20-24 40-44 60-64 80-84?? In 1996, the immigrant population represented 14% of Brant County s total population. Approximately 4% of the residents reported a home language other than English or French Polish and Italian predominantly.?? Compared to Ontario in 1996, Brant County residents had lower average education level, a larger proportion of them were employed in manual labour, and their average income was lower. However, in Brant County, the unemployment rate and the proportion of residents living below the poverty line were lower. Sources: Data were derived primarily from the 1996 Census (Statistics Canada).

Overview REPRODUCTIVE HEALTH?? Reproductive health covers the period prior to conception, and throughout pregnancy to labour and delivery. It includes fetal growth and development, factors essential to future health.?? In 1997 there were 1,349 livebirths in Brant County - 102 of these were among teenage mothers.?? Teen birth rates rose in Brant County between 1997 and 1999. In 1999, the teen birth rate (livebirths plus stillbirths) in Brant County (33/1,000) was almost twice the rate found in the neighbouring Health Unit areas and in Ontario as a whole (18/1,000). 1997 Pregnancy* Rates per 1,000 women by Age Age Residence 15-44 15-19 Brant County 68 47 Ontario 74 44 *Pregnancies include live births, still births, therapeutic abortions, miscarriages, and ectopic pregnancies.?? Between 1993 and 1997, births among single mothers in Brant County increased from 23% to 28%. By comparison, this proportion stayed at approximately 18% throughout Ontario.?? Low birthweight (LBW) is associated with infant mortality and the potential for future adverse health outcomes. Approximately 6% of all births in Brant County had a LBW in 1997 (4.3% of singleton births and more than half of all multiple births), similar to Ontario.?? Approximately 8% of Brant County babies were born prematurely half with a low birth weight. Premature birth has been found to put infants at risk of death or potential future health problems.?? Therapeutic abortion rates were lower in Brant County than in Ontario. In 1997, Brant County women aged 15-19 had 74 therapeutic abortions and those aged 20-44 had 240.?? Between 1993 and 1997 the perinatal mortality rate in Brant County was similar to the provincial rate, ranging from a high of 12 to a low of 7 per 1,000 births. In 1997 the rate was 10 per 1,000. Perinatal deaths include stillbirths and deaths prior to 7 days of age.?? A key group of congenital defects relevant to public health are neural tube defects, because they are preventable with adequate intake of folic acid (folate). The incidence of neural tube defects was less than five per year between 1993 and 1997 in Brant County.

Sources: Most currently available reproductive health data Health Planning Systems Databases (HELPS, 2000), Ontario Ministry of Health and Long-Term Care.

Brant County Community Health Status Report: 2001 LIFESTYLES AND HEALTH?? In Brant-Haldimand-Norfolk (BHN)* and Ontario, one third of all residents aged 12 and older indicated that they exercised more in the preceding year to improve their health. A much smaller proportion indicated that they lost weight, ate healthier, or smoked less. Four times as many people thought they should smoke less than the number who actually did so in the year. 35 30 25 20 15 10 5 0 Age Daily Smokers by Age, 1996/97 Percent * * 25 to 44 45 to 64 BHN 33 29 Ontario 27 21 * Statistically significan?? A larger proportion of residents in BHN (25%) than in Ontario (21%) reported that they were daily smokers. The proportion of daily smokers in Brant County was highest among males (29%) and young adults 20-44 (33%). reported having a regular smoker, compared to approximately 30% throughout Ontario. This measure is a good proxy for actual exposure to environmental tobacco smoke.?? In BHN, 40% of all households with children less than six years of age?? Approximately half of all teenagers in BHN and Ontario reported binge drinking (having more than five drinks at one time) in 1996/97. Among adults aged 15 and over, the proportion of binge drinkers was nearly double among males (50%) than females (28%).?? In 1996/97, in BHN and Ontario, nearly 50% of males and 65% of females 12 and older were physically inactive.?? One-third of BHN residents, compared to 28% in Ontario, had a body mass index (BMI) above 27, the level associated with a greater risk of heart disease and several other health problems.

?? A similar proportion of 15-19 year old teenagers in BHN (35%) as in Ontario (36%) reported having had sexual intercourse in 1996/97.?? Among women aged 50-69, a significantly smaller proportion had a mammogram within the preceding two years in BHN (55%) than in Ontario (64%). * Sources: 1996/97 Ontario Health Survey. Survey data were collected for Brant County and the Haldimand-Norfolk Regional Municipality (BHN), such that the results cannot be separated for each area independently.

Overview HOSPITALIZATIONS?? Between 1993/94 and 1998/99, hospitalization rates were on average 17% higher in Brant County than in Ontario.?? In 1998/99, there were 6,423 hospitalizations for males (43%) and 8,564 for females (57%), which included 1,532 for pregnancy and childbirth. With pregnancies removed, the leading causes of hospitalizations were similar between males and females in Brant County. Selected Hospitalizations, Brant County, 1998/99 Fiscal Year Causes # of Hospital Separations % of Total Separations Diseases of the Circulatory System 2243 15.0% Diseases of the Digestive System 1399 9.3% Diseases of the Respiratory System 1239 8.3% Injury and Poisoning 1126 7.5% Mental Disorders 931 6.2% Cancer 878 5.9% Source: Provincial Health Planning Database?? Hospitalizations by age group in Brant were as follows in 1998/99: 0-4 10%, 5-9 2%, 10-19 5%, 20-44 19%, 45-64 22%, and 65 and older 41%.?? Diseases of the Respiratory System plus Endocrine, Nutritional and Metabolic Diseases accounted for over a third of all hospitalizations among children aged 0-4 and 5-9 in Brant County. Asthma accounted for 9% of all hospitalizations for children under five.?? Mental Disorders, and Diseases of the Digestive and Respiratory Systems accounted for approximately 40% of all hospitalization among youth aged 10-19 and adults aged 20-44 in Brant.?? Diseases of the Circulatory and Digestive Systems plus Cancers accounted for approximately half of all hospitalizations among adults aged 45-64 and seniors aged 65-74 in Brant.?? Among seniors aged 75 and older in Brant, half of all hospitalizations were attributed to three leading causes: Diseases of the Circulatory, Respiratory and Digestive System?? In 1998/99, the standardized hospitalization rate for Diseases of the Circulatory System was 27% higher in Brant County than in Ontario. Over 40% of these hospitalizations in Brant County were due to ischaemic heart disease and 15% were due to strokes.?? Asthma accounted for 19% of all hospitalizations attributed to Diseases of the Respiratory System, while chronic obstructive pulmonary disease (COPD, asthma not included) and pneumonia accounted for 24% and 30% each, respectively.?? In 1998/99, the standardized hospitalization rate for Injury and Poisoning was 29% higher in Brant County than in Ontario. Over 24% of these hospitalizations in Brant County occurred because of accidental falls and 4% because of motor vehicle collisions. Sources: Most recent data available for production of the report Provincial Health Planning Database, 2000, Ontario Ministry of Health and Long-Term Care. Data include Six Nations and New Credit Reserve residents. Hospitalizations refer to hospital separations (i.e., discharges from hospital or deaths in the hospital).

Brant County Community Health Status Report: 2001 OTHER ILLNESS Cancer Incidence*?? In 1996 (the most recent year of cancer incidence data) there were 535 newly diagnosed cases of cancer in Brant County. Among these, the leading sites included prostate, lung, colorectal and female breast.?? Of the individuals newly diagnosed with cancer: 20% were less than 55 years of age; 50% were aged 55-74; and, 30% were 75 years of age and older. Activity Limitation & Disabilities +?? Based on self-reports, the 1996/97 OHS indicated that 13% of BHN population aged 12 and older was affected by long-term disability and handicaps, 16% were restricted in their activities, 11% required help in a series of tasks, and 4% received home care. Chronic Diseases +?? Based on self-reports, the 1996 OHS indicated that chronic conditions affecting BHN residents aged 12 and older included asthma (8%); arthritis (17%); high blood pressure (10%); and diabetes (3%). Communicable Diseases^ Sources: * Ontario Cancer Incidence Database, Ontario Ministry of Health and Long-Term Care, 2000. + 1996/97 Ontario Health Survey. Survey data were collected for Brant County and the Haldimand- Norfolk Regional Municipality (BHN), such that the results cannot be separated for each area independently. Many chronic diseases are likely underreported in this survey. ^ Reportable Disease Information System at the Brant County Health Unit, 2000.?? Infant/child vaccination coverage against such infectious diseases as measles, whooping cough and hepatitis B are high. Tetanus and diphtheria vaccinations decrease in the teen years, and by adulthood there are no reliable data on vaccine coverage rates. Influenza vaccination rates are high for residents and staff of long term care facilities, but reliable community-based data are unavailable.?? Between 1996 and 1999, the leading infectious diseases reported to the Brant County Health Unit included: Chickenpox (1902 cases); Chlamydia (383); Influenza (147); Campylobacter (137), and Salmonella (92). There was a notable increase in influenza between 1990-95 & 1996-99.

Overview MORTALITY?? Life expectancy at birth in Brant County, between 1994 and 1996, was 75 years for males and 81 years for females, which was significantly lower than Ontario by half a year.?? There were 1,080 deaths in Brant County in 1997: 39% were Diseases of the Circulatory System, 26% Cancer, 10% Diseases of the Respiratory System, and 25% other causes.?? 1997 death rates were significantly higher in Brant County than Ontario for Diseases of the Circulatory System (by 15%) and Diseases of the Respiratory System (by 24%).?? Premature deaths (deaths prior to age 75) were attributed mainly to Cancers (29%), Injuries (21%), and Diseases of the Circulatory System (18%).?? Deaths by age group in Brant County were as follows in 1997: aged 0-9 1%, aged 10-19 less than 1%, aged 20-44 5%, aged 45-64 14%, aged 65-74 18%, and aged 75 and older 61%. Leading Categories of Premature Death Brant County, 1997 Total Potential Years of Life Lost = 6,875 Congenital Anomalies Digestive Respiratory Other Circulatory Cancer Injury & Poisoning?? In Brant County and Ontario as a whole, injuries were the leading cause of death among children; adolescents; and young adults (i.e., aged 0-44).?? Cancers were the leading cause of death among adults aged 45-74, one quarter of which were attributable to lung cancer. Among women, breast cancer deaths equaled deaths from lung cancer.?? Diseases of the Circulatory System were responsible for the majority of deaths among seniors aged 75 and older (approximately half).?? Among deaths attributable to Diseases of the Circulatory system, strokes were 60% more frequent in Brant County than throughout Ontario.?? The majority of Cancer deaths were attributable to lung cancer. However, the standardized mortality rate for breast cancer was 55% higher in Brant County than Ontario.

Sources: Most recent data available for production of the report Health Planning System (HELPS), Ontario Ministry of Health and Long-Term Care, 2000. Data includes Six Nations and New Credit Reserve residents.

CONTACTS The complete report can be downloaded from the Grand River District Health Council website (www.grdhc.on.ca). For further information on the Health Status of Brant County residents, please contact: Adam Stevens, BSc MSc Epidemiologist Brant County Health Unit 753-4937, ext.219 astevens@bchu.org Joanna Krasowski, BSc MSc Epidemiologist, Health Planner Grand River District Health Council 756-1330, ext. 225 jkrasowski@grdhc.on.ca The mission of the Brant County Health Unit is: To enable all members of our community to strive for optimal health by providing leadership and excellence in public health. Integral to our work is our respect and caring for the community we serve. The mission of the Grand River District Health Council is: To build the Grand River community s capacity for high quality, integrated health services by providing leadership and facilitating change.